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- Title
PARANEOPLASTIC DERMATOMYOSITIS IN A CASE OF BORRELIOSIS - A CASE REPORT.
- Authors
TILEA, Anton-Mihai; GEORGESCU, Mihaela; BADEA, Mihai Alexandru; COSTACHE, Daniel Octavian; COSTACHE, Raluca Simona
- Abstract
INTRODUCTION Even though the dermatology textbooks fail to describe an association between borreliosis and dermatomyositis, there are at least ten cases reported so far that describe this link. CASE REPORT We present the case of a 45 years old female patient diagnosed with borreliosis (positive serology) that also presented, concurrent with the specifi c erythema chronicum migrans (ECM) on the left thigh, dermatomyositis like lesions consisting of facial oedema, violaceous poikiloderma of the face and upper trunk, Gottron papules on the dorsum of the hands and feet. The patient complained of fatigue, myalgia and arthralgia. Laboratory tests showed increased CK and LDH levels, negative anti Jo1 Atb and ANA, minimal EMG changes in a single muscle. Appropriate antibiotherapy induced an almost complete remission of the ECM lesions, however the dermatomyositis lesions persisted. Subsequently, the patient developed a signifi cant cervical lymphadenopathy. The lymph node biopsy showed metastasis of an undifferentiated squamous cell carcinoma. Cervical MRI revealed a tumour of the oropharynx. The patient further presented a deteriorated general condition with pruritic erythematous plaques on the trunk, upper and lower limbs, some of the lesions looking eczema like. A particular aspect of this case was the presence of small ulcerations in the axillary regions, with the tendency to heal with scarring and recurrence. CONCLUSIONS We consider our case to be the fi rst to describe an association between borreliosis and dermatomyositis occurring in a patient with an unknown malignancy. The aggressive evolution of this case suggests that this association may portend a poor prognosis.
- Publication
Balkan Military Medical Review, 2014, Vol 17, p218
- ISSN
1107-6275
- Publication type
Article